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Journal of Oncology
Volume 2009, Article ID 693458, 7 pages
Clinical Study

Estimation of Cachexia among Cancer Patients Based on Four Definitions

1Strategic Healthcare Solutions, LLC, P.O. Box 543, Monkton, MD 21111, USA
2College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA
3Amgen Inc., Thousand Oaks, CA 91320, USA

Received 12 February 2009; Accepted 2 May 2009

Academic Editor: David Ball

Copyright © 2009 Kathleen M. Fox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1) ICD-9 diagnostic code of 799.4 (cachexia), (2) ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3) prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4) 5% weight loss. Patients with cancer of the stomach, pancreas, lung, colon/rectum, head/neck, esophagus, prostate, breast, or liver diagnosed between 1999 and 2004 were followed for cachexia. Results. Of 8541 cancer patients (60% men and 55% Caucasian), cachexia was observed in 2.4% of patients using the cachexia diagnostic code, 5.5% expanded diagnoses, 6.4% prescription medication definition, and 14.7% with 5% weight loss. Conclusions. The proportion of patients with cachexia varied considerably depending upon the definition employed, indicating that a standard operational definition is needed.